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HIPAA-Compliant Email Marketing: FAQ

Tuesday, November 21st, 2023

Email is an essential channel for most marketers. However, HIPAA regulations raise many questions for healthcare marketers who need to execute email marketing campaigns without violating patient privacy.

HIPAA is a complicated law that offers a lot of guidance but does not require the use of any specific technologies to protect patient privacy. The ambiguity causes a lot of confusion for marketers trying to integrate email into their marketing strategy. This article addresses some frequently asked questions about HIPAA-compliant email marketing and offers advice for securing patient data and futureproofing your marketing.

Do generic practice newsletters need to be protected?

Some marketers assume practice newsletters do not contain health information and, therefore, do not fall under HIPAA requirements. However, this assumption is often incorrect. Many are surprised to learn that protected health information can be implied from seemingly benign information.

In this way, many generic email newsletters often indirectly contain PHI because they are sent to lists of current patients. Email addresses are individually identifiable and combined with the email content; it may imply that they are patients of the practice. For example, say you send a “generic” newsletter to the patients of a dialysis clinic. An eavesdropper may be able to infer that the recipients receive dialysis. Therefore, the email reveals information about an individual’s health treatment, is PHI, and should be secured in compliance with HIPAA regulations.

In some cases, it can be complicated to determine what is PHI and what is not. Using a HIPAA-compliant marketing solution is best to avoid ambiguity and ensure security.

How Do I Find a HIPAA-Compliant Email Marketing Vendor?

Unfortunately, using broadly popular email marketing platforms is not recommended. Many of these platforms were designed for e-commerce businesses and are not secure enough to meet HIPAA requirements. We do not recommend using a solution not specifically equipped to meet the healthcare industry’s unique security and compliance needs. To determine if your email marketing provider is compliant, they must meet three broad criteria at a minimum.

  1. The vendor must sign a Business Associate Agreement outlining how they plan to secure your data and what they will do in the event of a breach.
  2. Encrypt data at rest when it is stored in their systems.
  3. Encrypt email messages and data in transit as it is sent to the recipients.

 

email marketing vendor comparison

Not all vendors will be up to the task. Carefully vet your email marketing vendors to ensure they are taking steps to secure data and protect patient privacy.

What is an Email API?

API is an acronym that stands for “Application Programming Interface.” An email API gives applications (like CRMs, CDPs, or EHRs) the ability to send emails using data from the application. Email APIs also return campaign data to the platform or dashboards so you can assess the effectiveness of your marketing efforts. Trigger-based transactional or marketing emails are ideal for sending with an email API. In this situation, emails are sent when pre-determined conditions in the application are met. Healthcare organizations may use email APIs to send appointment reminders using electronic health records system data about a patient’s upcoming appointment.

Email APIs enable the automation of common email workflows. However, they are not interchangeable with email marketing platforms. Email APIs do not include the contact management systems standard in most email marketing platforms because all that data lives within the application they connect to. In addition, email API tools typically do not include drag-and-drop editor tools or other design features that help your emails stand out.

Does HIPAA permit providers to send unencrypted emails with PHI to patients?

Encryption is an addressable standard under the HIPAA Security Rule, but that does not mean it is optional. The HIPAA Privacy Rule does not explicitly forbid unencrypted email. Still, it does state that “other safeguards should be applied to protect privacy reasonably, such as limiting the amount or type of information disclosed through the unencrypted email.”

In addition, the Department of Health and Human Services also states that “covered entities are permitted to send individuals unencrypted emails if they have advised the individual of the risk, and the individual still prefers the unencrypted email.” Some organizations use waivers to inform patients of the risks and acquire permission to send unencrypted emails.

However, we do not recommend this approach for several reasons:

  1. Keeping track of waivers over time and recording status changes and updates is challenging.
  2. Signed waivers do not insulate you from the consequences of a HIPAA breach.
  3. And finally, using waivers to send unencrypted emails doesn’t eliminate your other HIPAA obligations like data retention and disposal. Using a HIPAA-compliant solution is more manageable and eliminates ambiguity.

Can patients exercise their right of access by receiving PHI via unencrypted email?

Yes, but they must be fully informed of the risks and sign waivers acknowledging them. The caveats in the previous answer apply. It’s always better to utilize an encryption tool to protect patient data.

Is Microsoft 365 or Exchange 365 encryption sufficient for marketing emails?

Microsoft 365 can be configured with Office Message Encryption (OME) to comply with HIPAA. However, the program is not well-suited to send marketing emails. OME primarily relies on portal pickup encryption, in which the message is stored securely on a server and requires the recipient to log in to the portal to read the email. If you are a marketer trying to increase engagement, the portal adds a barrier to access that many will not cross. Light-PHI marketing messages are best sent using TLS encryption. TLS-encrypted messages arrive in the recipient’s inbox just like a regular email and do not require a user to log in to read the message.

TLS versus Portal Pickup email encryption

In addition, Microsoft 365 is not configured to send high volumes of email. If you plan to send large marketing campaigns, you could unintentionally disrupt regular business communications by sending all the messages through the same infrastructure. You should separate your business and marketing email sending to protect your IP reputation and achieve your desired sending throughput.

What are common email marketing use cases for healthcare?

Email marketing in healthcare is not restricted to boring practice newsletters. When you utilize tools that enable the use of PHI in your targeting and personalization efforts, the sky is the limit. With consumer preferences shifting toward digital communications, marketers willing to utilize the email channel and tactics like segmentation and personalization can see better results.

Email is an excellent way to communicate with patients. A sampling of ways that healthcare marketers can use email include:

  • engaging patients in their healthcare journey
  • educating patients about their healthcare conditions and treatments
  • improving attendance and scheduling
  • retaining patients
  • increasing preventative procedures
  • collecting data on the patient experience
  • improving patient satisfaction

Conclusion

HIPAA can be difficult to understand, but choosing the right tools and adequately vetting your vendors makes it easy to execute HIPAA-compliant email marketing campaigns. If you are interested in learning more about LuxSci’s easy-to-use, Secure Marketing platform, please contact our sales team.

Tags: email api, email marketing, encrypted email, faq, hipaa compliance, HIPAA-compliant email marketing, mutual consent, quasi compliance, quasi hipaa compliance, unencrypted email
Posted in Email Marketing
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6 Email Marketing Best Practices for Healthcare

Tuesday, November 14th, 2023

Email marketing can be a powerful tool for healthcare organizations, but it requires careful planning and execution because of HIPAA compliance requirements. In this blog post, we will discuss email marketing best practices to help healthcare marketers achieve their goals. 

woman viewing email program

1. Define Your Campaign Goals

The success of any email marketing campaign depends on the goals you want to achieve. However, because healthcare organizations are often not selling products to their patients, marketers can be confused about how to set measurable goals for their campaigns that aren’t tied to revenue generation.

Healthcare marketers want to use email marketing campaigns for various purposes, including patient engagement, education, and retention. Some possible objectives of your campaigns could be:

  • New patient acquisition
  • Re-engaging lapsed patients
  • Spreading awareness about vaccines, treatments, or medical conditions
  • Increasing treatment or medication adherence
  • Collecting survey responses or patient-reported outcomes

All of these campaign objectives will correlate with different metrics. Identifying the campaign goal and the corresponding metrics you need to track is critical before selecting the audience and crafting the content.

2. Select Your Audience

Gone are the days of sending giant email blasts to your entire contact list. The best email marketers are creating highly targeted campaigns for specific audiences. Healthcare marketers using patient data in their audience targeting efforts are at an advantage. They can use patient information to create distinct audience segments. Targeting a patient population with common attributes makes it easier to craft a relevant message to drive clear results. For example, marketers can create more relevant campaigns when they can divide their patient population into subgroups based on shared characteristics like diagnoses, risk factors, and demographic data.

3. Personalize Your Content

Once you have clearly defined your goal and your audience, it’s essential to use personalization techniques to craft relevant messaging. Healthcare consumers expect more personalization from their providers and want to receive messages that tie into their past experiences. Generic, irrelevant messaging is more likely to annoy patients than get them to act. Healthcare marketers are lucky to have a wealth of data points to use in their messaging, but they must be aware of patient privacy and take steps to secure their messaging. When you have taken the appropriate steps to secure patient data, including protected health information in email messages is possible. This improves the patient experience and makes it easier for healthcare marketers to achieve their objectives.

4. Use A Clear Call-to-Action

Your emails should include a clear call-to-action (CTA) that encourages your audience to take the desired action. These actions may include scheduling an appointment, downloading a resource, logging into a patient portal, filling out a survey, or contacting your organization. Ensure that your CTA is prominent, stands out from the rest of your content, and ties back to the goal of your campaign. Most importantly, implement appropriate tracking technologies so you can see how many email recipients followed through on the CTA.

Don’t include too many calls to action in one message! Including multiple prompts may confuse the recipient and make it more difficult for your team to understand how the campaign performed.

5. Review Your Data

Finally, it’s essential to monitor your email metrics to evaluate the success of your campaigns. Some key metrics may include open rates, click-through rates, surveys completed, successful logins, appointments scheduled, and other relevant metrics that tie back to your goals. Use this data to refine your email marketing strategy, trigger follow-up campaigns and marketing activity, and optimize future campaigns. Use APIs or webhooks to ensure your email campaign statistics are tied into marketing dashboards to get a holistic view of how your campaigns are performing.

6. Choose an Email Marketing Platform Designed for Healthcare

Finally, to use the tactics recommended above, it’s necessary to use a HIPAA-compliant email marketing platform. Segmenting audiences and personalizing content requires the use of protected health information. Therefore, it must be secured in compliance with HIPAA. You must select a platform that can protect data both at rest and in transit to utilize the power of your data fully.

LuxSci’s HIPAA-compliant Secure Marketing was designed to meet the needs of healthcare marketers and enables the use of PHI at scale. Contact our sales team to learn more about our capabilities and email marketing best practices.

Tags: email analytics, email marketing, ePHI, hipaa, hipaa compliance, patient engagement, personalization, phi, secure email, segmentation
Posted in Email Marketing
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Improve the Patient Experience with Personalized Patient Engagement

Tuesday, November 7th, 2023

Patient expectations of healthcare providers have dramatically changed in the last decade. The introduction of technology and the widespread adoption of digital communications in other industries have increased the pressure on healthcare providers to provide a comparable experience.

The 2023 Healthcare Consumer Perspectives on Digital Engagement and AI report conducted by Dynata Research found that more patients are adopting digital tools to manage their health and want their providers to provide a consistent experience across all channels. To improve the patient experience, a personalized patient engagement strategy is necessary.

Personalized Patient Engagement Improves the Patient Experience

Healthcare organizations manage so much data that can be used to improve the patient experience. As audience segmentation and personalization techniques have become more common in other industries like e-commerce and personal care, consumers are starting to expect the same experiences from their healthcare providers.

For example, media streaming services make personalized recommendations for new shows based on what you have previously watched. People like these features because it helps them discover new content they may not know about. Likewise, patients are beginning to expect a similar personalized patient engagement experience from their healthcare provider. Suppose a patient wants to control their diabetes diagnosis and communicates with their provider about this at an appointment. Afterward, when they log into the patient portal or receive follow-up information, they expect to receive relevant information that aligns with that provider’s conversation.

survey data patient preferences

Proactive, personalized patient engagement can also drive patients to make the right choices in managing their health. By sending patients the correct information at the right time in the context of their individual health journey, it is easier for them to manage their own health.

Shifting Preferences for Digital Tools Enable Personalized Patient Engagement

As more people are open to incorporating digital tools into their healthcare journeys, it has revealed new patient engagement opportunities. Several reasons led healthcare organizations to embrace digital tools. The coronavirus pandemic kicked off a necessary wave of digital transformation because of the rapid transmission of the disease through close contact. The desire to use these tools has remained strong even after institutions largely reopened in 2021. Patients have also shown no desire to go back to the way things used to be. Digital channels and tools like patient portals, email, medical devices, and mobile applications all make it easier for patients to manage their health on the go.

shifting digital preferences survey data

As patient preferences have shifted to embrace digital channels and technologies, organizations that can implement digital-first personalized patient engagement strategies intelligently are more likely to have satisfied and healthier patients. However, healthcare organizations must strive to provide a consistent experience across both in-person and digital avenues. According to the survey, the number one reason consumers would consider changing their healthcare provider is “complex or confusing experiences.” Poorly implemented and executed patient engagement can negatively impact the patient experience and retention, so it’s essential to be thoughtful in your approach.

How to Personalize the Patient Experience

Traditionally, HIPAA compliance requirements have made it difficult for healthcare providers to utilize protected health information (PHI) in personalized patient engagement efforts. Using PHI in communications is vital to craft messaging relevant to the patient’s health journey. However, when transmitting and storing PHI, HIPAA regulations must be followed to protect patient privacy.

The first step to executing personalized patient engagement involves selecting the right tools. Many traditional digital engagement tools are not designed to meet these stringent encryption and security requirements. By selecting tools that meet HIPAA’s technical requirements (like LuxSci’s Secure Marketing and Secure High Volume Email) and properly training employees, healthcare teams can employ the same segmentation and personalization techniques to reach patients with relevant and consistent communications.

Conclusion

Personalizing patient engagement is one way to improve patient marketing and retention. Contact us today to learn more about improving the patient experience with secure email communications.

Tags: digital health, email marketing, ePHI, hipaa compliance, patient engagement, patient experience, personalization, segmentation
Posted in Email Marketing
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What is a Secure Email Gateway?

Tuesday, October 24th, 2023

As threats to email security are increasing, organizations are looking for ways to enhance their security and reduce risk. One option is a secure email gateway. In this article, we review what secure email gateways are and how they can be used to secure sensitive data as it flows into and out of your accounts.

secure email sending button on keyboard

Protect Your Accounts With A Secure Email Gateway

Secure email gateways are an excellent way to strengthen the security of your email accounts without a costly switch to a new email provider. They layer on top of your existing email accounts to encrypt messages, scan for threats, and even capture messages for archival or backup purposes. They can also hide the sender’s IP address because messages are routed through another email infrastructure before delivery to the recipient. If you are concerned about increasing risks to sensitive data, secure email gateways offer a simple and effective way to enhance your email security.

How Do Secure Email Gateways Work?

When using a secure email gateway, your messages are routed to a separate server before being sent or received. When sending an outbound message with LuxSci’s Secure Connector, it is routed through our SecureLine encryption before being securely delivered to the recipient. A copy of the message may also be sent to an independent email archive to help meet compliance requirements for message retention.

 

LuxSci Secure Connector

 

For incoming messages, the gateway can employ email filtering technology to quarantine suspicious messages. These technologies can scan incoming messages and prevent spammers and scammers from reaching employee inboxes and wreaking havoc. Just like with outbound email sending, the gateway can also capture a copy of inbound messages and retain them in an independent message archive.

The exact features of a secure email gateway will vary from vendor to vendor, but these represent some of the core functions that these tools provide. Simply put, a secure email gateway protects both incoming and outgoing messages to ensure that sensitive data is guarded from threats.

Why Choose a Secure Gateway?

There are two main reasons to implement a secure email gateway: the security and compliance benefits and their ease of use. Let’s look at each.

Compliance and Security Benefits

Many companies, like healthcare organizations, must comply with regulations for protecting patient or customer data. Many organizations grapple with the best way to secure potentially sensitive communications without interfering with or slowing down critical business workflows. Because secure email gateways layer on top of existing email accounts, they offer a speedy way to bring your organization into compliance with data security and retention guidelines.

As email continues to be an important channel for essential business communications, all organizations can benefit from protecting their employee accounts and reducing their risk and liability.

Easy to Administer and Use

Another benefit of using a secure email gateway is that your organization does not need to switch your primary email provider to enhance its security. Changing to a more secure email provider can be extremely challenging, especially if you have a lot of users with a lot of data that needs to be migrated to a new system. Add on the training time, and some organizations will find that switching email providers is a significant burden on the organization.

Installing a secure email gateway is very easy for account administrators and often does not require additional training or implementation for email users. Employees can continue to use their regular Microsoft or Google email accounts and do not need to take additional steps to learn an entirely new email program. With 73% of breaches in the healthcare industry caused by human factors, implementing tools that don’t rely on employee decision-making is essential.

Learn More About LuxSci’s Secure Connector

LuxSci’s Secure Connector is unlike other secure email gateways in that it encrypts every email automatically to reduce the risk of breaches caused by human errors. LuxSci provides the flexibility to opt-in to more secure methods of encryption for highly sensitive messages. Email filtering and archival tools are also available to reduce risk and improve resilience in the case of a cyber incident. Contact our sales team to learn more about our email security tools.

Tags: email archival, email encryption, email filtering, email security, hipaa compliance, secure connector, secure email gateway
Posted in Email, LuxSci Library: Email Programs and Devices
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How Online Tracking Technologies & Data Collection Threaten Patient Privacy

Tuesday, October 10th, 2023

Many healthcare marketers use online tracking technologies to gather user information as they interact with a website or mobile application. After several breaches tied to improper uses of third-party tracking pixels, the Department of Health and Human Services has clarified that data collected via online tracking technologies are often PHI and must be secured according to the Privacy Rule. This decision has put many organizations at a crossroads- how can they balance patient privacy with the financial pressures to grow their business and provide a superior digital experience?

online tracking technologies

What are Online Tracking Technologies?

Tracking technologies collect information about website visitors in various ways, many of which are invisible to the user. Some of the most common types of tracking technologies include cookies, web beacons or tracking pixels, session replay scripts, and fingerprinting scripts. Mobile apps also include tracking codes within the application to enable the collection of user information.

After collecting the information, it is analyzed to create insights about users’ online activities. Marketers often use the data to create highly targeted advertising campaigns. In the case of third-party tracking technologies, they may continue to track users and gather information about them even after they leave and visit other websites. You’ve likely experienced this when online shopping. You look at a pair of shoes on a retailer’s website, and then they continue to follow you and appear as ads as you browse other websites and social media platforms. However, if you replace ads about shoes with advertisements for treatments for an individual’s medical conditions, this raises serious patient privacy concerns.

What Does HIPAA Say About Online Tracking Technologies & Data Collection?

Online tracking technologies have been widely utilized for over a decade but have only recently been considered in the context of health data privacy. The Dobbs vs. Jackson Women’s Health Organization decision by the Supreme Court in June 2022 kicked off a wave of reporting on how reproductive health information was collected and sold online. Some worried that this information could be used in court cases to convict people who sought abortions, leading to significant concerns over digital health data privacy.

In this context, researchers began looking at the websites of major health systems to explore how they used trackers to collect and transmit data. A study revealed that 99% of US hospitals employed online data trackers that transmitted visitors’ information to a broad network of outside parties, including major technology companies, data brokers, and private equity firms. Some hospitals even employed these trackers on internal patient portal web pages, potentially exposing highly sensitive patient data to advertisers.

As a result of the confusion surrounding this issue and the seemingly clear violation of HIPAA rules, OCR issued a bulletin explaining how covered entities can and cannot use tracking technologies on their websites.

You would think that is the end of the story. However, there is still a lot of confusion surrounding the proper use of these technologies. In July 2023, the FTC and OCR issued another warning to 130 hospital systems that continued deploying online tracking technologies despite the bulletin.

Gray areas still exist in how the bulletin is interpreted. The American Hospital Association recently asked OCR to reconsider its guidance, stating it contradicts interoperability efforts. As this situation evolves, healthcare providers must be aware of the risks of online tracking technologies and how they can balance risk with their business objectives.

How is this Data Protected Health Information?

One of the reasons this issue flew under the radar for so long is that it is not necessarily obvious that the information collected by these pixels qualifies as PHI. It may not be evident to end-users, but tracking technology vendors can infer a lot of personal data through tracking technologies placed on a healthcare provider’s website. Some of the information that can be captured by tracking technology could include:

  • medical record numbers
  • email addresses
  • appointment dates or requests
  • IP addresses
  • medical device IDs
  • geographic locations

Marketers may not realize that individually identifiable information collected on a covered entity’s website or mobile app is often protected health information (PHI). Even if the individual has no pre-existing relationship with the healthcare provider, DHHS’s recent update is clear that this information is protected. Collecting this information establishes a relationship between a covered entity and an individual relating to their past, present, or future provisioning of health care. A visit to a healthcare provider’s website may be the first step taken by a future patient in accessing healthcare treatment.

There is always some gray area when defining PHI, but it’s better to be safe than sorry in this case. If you are using any online tracking technology, you must confirm that it is processing and transmitting data in a way that aligns with HIPAA regulations.

How Healthcare Marketers Can Protect Patient Privacy

First of all, if you plan to use tracking technology on your website, the vendor needs to be a business associate of your organization. In these circumstances, covered entities must ensure that the disclosures made to such vendors are permitted by the Privacy Rule and enter into a business associate agreement (BAA) that outlines how PHI will be protected.

Think carefully about what data needs to be collected and why. In other industries, collecting user data and selling it to third parties or using it in advertising efforts is very common. Healthcare marketers must be more intentional in using online tracking technologies and take additional steps to ensure the data is processed and transmitted securely. Do not install tracking pixels without careful consideration. As many hospital systems learned, failing to do so can have profound privacy and compliance implications.

If you want to follow up with patients who browsed your website for available appointments, you must ensure their data is secure from when it is collected through the transmission to other systems. For example, a patient may enter their name, email address, phone number, and desired appointment time into an online form. When they click “Submit,” where and how is this data transmitted and stored? As they browse the available appointments and doctors, your system may log which web pages they visit and store them in a CRM, CDP, or another platform. If they leave without making an appointment, what do you do with the data you collect? If you transmit this data to other advertising or marketing platforms, you will also need business associate agreements with those vendors. As you can see, it can get complicated very quickly.

HIPAA-Compliant Marketing Technology

LuxSci’s Secure Form and Secure Marketing technologies offer a few ways to address the patient privacy issues associated with online data collection and transmission. Our fully HIPAA-compliant solutions enable you to securely collect data on your website and use secure email to engage prospects. Contact our sales team to learn more today.

Tags: data collection, email marketing, ePHI, hipaa compliance, online tracking, online tracking technology, patient privacy, phi, pixel tracking, tracking pixel
Posted in Email Marketing, LuxSci Library: HIPAA
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